clobetasol and Skin-Ulcer

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Clobetasol; Dermatitis; Female; Glucocorticoids; Humans; Hypertension; Ischemia; Male; Necrosis; Skin Ulcer

Topics: Adenoma; Administration, Topical; Aged; Anti-Infective Agents, Local; Bromocriptine; Clobetasol; Drug Eruptions; Glucocorticoids; Humans; Male; Pituitary Neoplasms; Silver Sulfadiazine; Skin Ulcer

Topics: Aged; Bile Duct Neoplasms; Clobetasol; Glucocorticoids; Hand Dermatoses; Humans; Male; Pruritus; Skin; Skin Ulcer; Sweet Syndrome

Pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment.. We sought to estimate the effectiveness of topical therapies in the treatment of patients with PG.. This was a prospective cohort study of UK secondary care patients with a clinical diagnosis of PG that was suitable for topical treatment (recruited between July 2009 and June 2012). Participants received topical therapy after normal clinical practice (primarily topical corticosteroids [classes I-III] and tacrolimus 0.03% or 0.1%). The primary outcome was speed of healing at 6 weeks. Secondary outcomes included the following: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality of life; treatment failure; and recurrence.. Sixty-six patients (22-85 years of age) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28 of 66 (43.8%) ulcers healed by 6 months. The median time to healing was 145 days (95% confidence interval, 96 days to ∞). Initial ulcer size was a significant predictor of time to healing (hazard ratio, 0.94 [95% confidence interval, 0.88-1.00); P = .043). Four patients (15%) had a recurrence.. Our study did not include a randomized comparator.. Topical therapy is potentially an effective first-line treatment for PG that avoids the possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone.

Topics: Administration, Cutaneous; Adult; Aged; Anti-Inflammatory Agents; Clobetasol; Dermatologic Agents; Female; Humans; Male; Medication Adherence; Middle Aged; Prospective Studies; Pyoderma Gangrenosum; Quality of Life; Recurrence; Skin Ulcer; Tacrolimus; Treatment Outcome

The ulcerative variant of lichen planus (LP) commonly involves the oral mucosa but is uncommon and difficult to treat when located on other areas. We describe an unusual case of ulcerative LP involving several surfaces, including the palms and scrotum, in a 50-year-old man with hepatitis C. The patient was recalcitrant to treatment with conventional therapy but obtained clearance with a sustained response using low molecular weight heparin (LMWH). This treatment is an option for patients with LP who are not ideal candidates for standard therapy.

Topics: Anti-Inflammatory Agents; Anticoagulants; Clobetasol; Genital Diseases, Male; Hand Dermatoses; Heparin, Low-Molecular-Weight; Hepatitis C; Humans; Immunosuppressive Agents; Lichen Planus; Male; Middle Aged; Scrotum; Skin Ulcer; Tacrolimus